Podcast
Questions and Answers
What is the cell of origin for Odontogenic Epithelium Tumours?
What is the cell of origin for Odontogenic Epithelium Tumours?
Which type of odontogenic tumour includes cells from both the enamel organ and dental papilla?
Which type of odontogenic tumour includes cells from both the enamel organ and dental papilla?
Which statement best describes general odontogenic tumours?
Which statement best describes general odontogenic tumours?
What is the common clinical presentation of odontogenic tumours?
What is the common clinical presentation of odontogenic tumours?
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Which type of odontogenic tumour has a high recurrence rate if simply curetted due to its infiltrative growth pattern?
Which type of odontogenic tumour has a high recurrence rate if simply curetted due to its infiltrative growth pattern?
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What is the most common clinical presentation of ameloblastomas?
What is the most common clinical presentation of ameloblastomas?
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Which odontogenic tumour is known for its huge growth potential?
Which odontogenic tumour is known for its huge growth potential?
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Which age group is least likely to have ameloblastomas?
Which age group is least likely to have ameloblastomas?
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What distinguishes odontogenic epithelium tumours from ectomesenchymal tissue tumours?
What distinguishes odontogenic epithelium tumours from ectomesenchymal tissue tumours?
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What radiographic appearance is commonly associated with ameloblastomas?
What radiographic appearance is commonly associated with ameloblastomas?
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Which type of odontogenic tumour is described as rare in occurrence?
Which type of odontogenic tumour is described as rare in occurrence?
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What is the characteristic histopathological feature of ameloblastomas?
What is the characteristic histopathological feature of ameloblastomas?
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What behavior do malignant odontogenic tumours typically exhibit?
What behavior do malignant odontogenic tumours typically exhibit?
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What is the treatment of choice for conventional ameloblastomas?
What is the treatment of choice for conventional ameloblastomas?
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What distinguishes mixed odontogenic tumours from other types based on the text provided?
What distinguishes mixed odontogenic tumours from other types based on the text provided?
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Which variant of unicystic ameloblastoma is associated with a papillary appearance in the tumor lumen?
Which variant of unicystic ameloblastoma is associated with a papillary appearance in the tumor lumen?
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What is the typical radiographic presentation of adenomatoid odontogenic tumors?
What is the typical radiographic presentation of adenomatoid odontogenic tumors?
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'Round organoid masses of spindle-shaped epithelial cells' is a characteristic histopathological finding in which odontogenic tumor?
'Round organoid masses of spindle-shaped epithelial cells' is a characteristic histopathological finding in which odontogenic tumor?
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Which odontogenic tumor has a strong predilection for teenagers, rarely occurring in individuals over 30 years old?
Which odontogenic tumor has a strong predilection for teenagers, rarely occurring in individuals over 30 years old?
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What is the most common presenting sign of Calcifying Epithelial Odontogenic Tumor (CEOT)?
What is the most common presenting sign of Calcifying Epithelial Odontogenic Tumor (CEOT)?
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Study Notes
Classification of Odontogenic Tumours
- Based on cell of origin:
- Tumours of Odontogenic Epithelium (dental lamina + enamel organ)
- Mixed Tumours (odontogenic epithelium + ectomesenchymal tissue with or without dental hard tissues)
- Tumours of Ectomesenchymal Tissue (cells of the dental papilla)
Odontogenic Tumours - General Rules
- Very uncommon
- Generally benign, although some may exhibit aggressive behaviours
- Malignant odontogenic tumours are extremely rare
Clinical Presentation
- Ranges from incidental finding to an asymptomatic expansile mass
- Can present as unilocular or multilocular lesions
- May or may not be associated with a tooth
Odontogenic Epithelium Tumours (benign)
- Ameloblastoma
- Conventional, Unicystic, Extra-osseous/Peripheral, or Metastasizing
- Adenomatoid Odontogenic Tumour (AOT)
- Calcifying epithelial odontogenic tumour (rare)
- Squamous odontogenic tumour (rare)
Ameloblastoma
- Benign tumour of odontogenic epithelium
- Huge growth potential and infiltrative growth pattern
- High recurrence rate if simply curetted
- Can extend into base of the brain and cause death if left untreated
Clinicopathologic Types of Ameloblastoma
- Conventional
- Unicystic
- Peripheral
- Metastasizing (very rare)
Epidemiology of Ameloblastoma
- Rare under the age of 10
- Uncommon in 10-19 years old
- Equal prevalence in 3rd to 7th decade
- 80-85% occur in the mandible (usually posterior)
Clinical Presentation of Ameloblastoma
- Painless swelling or expansion
- Capable of significant growth if left untreated
- Pain and paresthesia are uncommon
Radiographic Presentation of Ameloblastoma
- Multilocular radiolucency (soap bubble or honeycomb appearance)
- Expansile lesion with thinning of the cortices
- Found in any relation to the teeth or with no adjacent tooth
- Radiographic margins range from well- to ill-defined, but usually somewhat defined
- Root resorption is common
Histopathology of Ameloblastoma
- Hyperchromatic nuclei of ameloblast-like basal epithelium
- Stellate reticulum-like cells
- Some discrete keratin formation in the middle
- An ameloblastoma island is like an inverted dental organ, with the ameloblastoma-like cells on the periphery
Unicystic Ameloblastoma
- Cystic tumour lined by odontogenic epithelium with a low recurrence rate
- Tend to present in the second decade most commonly
- 90% in mandible – predilection for the posterior
- Clinical and Radiographic Presentation: Unilocular, pericoronal radiolucency
Variants of Unicystic Ameloblastoma
- Intraluminal
- Papillary appearance to the lumen of the tumour (gross appearance)
- Plexiform growth pattern in the odontogenic epithelium
- Luminal
- Mural
Management and Prognosis of Ameloblastomas
- Conventional (conventional and mural)
- 5-17% recurrence rate with resection
- 30-35% with curettage or enucleation
- Unicystic (luminal and intraluminal)
- 6-37% recurrence
- Peripheral ameloblastoma
- No recurrence with simple excision
Adenomatoid Odontogenic Tumour (AOT)
- Definition: Uncommon benign tumour of odontogenic epithelium
- Epidemiology: Teenagers – rarely over age 30, strong female predilection (2:1), loves the maxilla (2:1)
- Clinical Presentation:
- 2/3 adolescents
- 2/3 females
- 2/3 maxilla
- 2/3 associated with unerupted root
- Radiographic: Initially radiolucent, then flocculent opacities (“snowflakes”)
- Treatment: Encapsulated – thus enucleates cleanly on curettage, when a tooth is involved, the tooth is extracted, rarely recurs
Calcifying Epithelial Odontogenic Tumour (CEOT)
- Definition: Benign, aggressive neoplasm of stellate intermedium and/or reticulum
- Less aggressive than ameloblastoma
- Epidemiology and Clinical Presentation: Rare, most common presenting sign is a painless, slow-growing swelling
- Radiographic Presentation: Unilocular (more in maxilla) or multi-locular, margins are typically scalloped and well-defined; may be corticated or ill-defined
- Histopathology: Clusters of polyhedral epithelial cells, often intercellular bridges, large and dysplastic-looking cells, background fibrous stroma
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Description
Learn about the classification of odontogenic tumours based on the cell of origin, including tumours of odontogenic epithelium, mixed tumours, and tumours of ectomesenchymal tissue. Understand the general rules and characteristics of odontogenic tumours.
